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Regional soft tissue pains: alias myofascial pain?
1Chedoke Rehabilitation Services, Hamilton Health Science Corporation, Ontario, Canada.
Bailliere'S Clinical Rheumatology
|August 13, 1999
Summary
The existence and clinical utility of myofascial pain diagnoses are debated, requiring further research into diagnostic reliability and specificity for effective evidence-based management of musculoskeletal pain.
Area of Science:
- Pain Medicine
- Musculoskeletal Disorders
- Diagnostic Criteria
Background:
- The concept of myofascial pain is debated, with differing views on whether it is distinct from or synonymous with regional musculoskeletal pain.
- A clear understanding of myofascial pain pathophysiology is lacking, with contrasting theories suggesting either a specific mechanism or non-specific pain from multifactorial influences.
- The current literature lacks consensus on the definition and diagnostic features of myofascial pain syndromes.
Purpose of the Study:
- To critically evaluate the evidence for the existence and clinical utility of myofascial pain diagnoses.
- To assess the benefits of managing patients based on a myofascial pain diagnosis.
- To review the evidence-based management strategies for myofascial pain.
Main Methods:
- Systematic review of the literature on myofascial pain and regional musculoskeletal pain.
- Analysis of diagnostic reliability, sensitivity, and specificity issues.
- Evaluation of clinical usefulness based on healing, disability, and pain course.
Main Results:
- Evidence for the distinct existence of myofascial pain syndromes remains inconclusive due to diagnostic reliability and specificity challenges.
- The clinical usefulness of the myofascial pain diagnosis is uncertain, impacting the ability to conduct controlled treatment trials.
- An epidemiological approach is proposed to define strata of regional musculoskeletal pain for future research.
Conclusions:
- Clarification of diagnostic criteria and resolution of reliability issues are essential for establishing myofascial pain as a distinct and clinically useful diagnosis.
- Further research is needed to determine the efficacy of myofascial pain-specific management strategies.
- An epidemiological framework may facilitate research into the course, prognosis, and treatment of regional musculoskeletal pain, despite ongoing conceptual debates.
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